Drilling holes into concrete or metal ceilings is one of the most physically demanding tasks performed in construction. The work is done overhead with rotary impact hammer drills that weigh up to 40 N. The task is associated with pain and musculoskeletal disorders at the wrist, forearm, shoulder, and back. The mechanism of injury is thought to be the high forces and non-neutral shoulder and wrist postures applied during drilling. Previously, we described a field study of a foot lever and inverted drill press intervention devices that received poor usability ratings compared with the usual method for overhead drilling based on problems with mobility and productivity. Using a participatory intervention model, feedback from construction workers (N = 13) was used to develop a new intervention design that incorporated a wheeled tripod base and a unique method of aligning the drilling column to vertical. A different group of construction workers (N = 23) evaluated usability and fatigue of the new device during their regular overhead drilling in comparison with the usual method. Four of 12 usability ratings were significantly better with the intervention device compared with the usual method. Subjective shoulder fatigue was less with the new intervention (1.1 vs. 3.3; scale 0 to 5; p < 0.001). This difference was supported by objective outcome measures; the mean hand forces during drilling were 26 N with the intervention compared with 245 N with the usual method. The percentage of time with the shoulder flexed or abducted to more than 60 degrees was less with the intervention compared with the usual method (21 vs. 40%; p = 0.007). There was significantly less head extension with the intervention compared with the usual method. There were no significant differences in overall productivity between the two methods. This study demonstrates that a new intervention device for overhead drilling has improved usability and subjective fatigue ratings compared with the usual method. These improvements are most likely due to the reduced hand forces, reduced shoulder abduction and flexion, and reduced drilling time.